脳梗塞急性期治療

The number of patients who develop acute ischemic stroke （AIS） increases year after year. Accordingly, the number of patients with disability also goes on increasing. This situation affects increment of medical expense in Japan. Therefore, managing the stroke patients is the urgent need. Recently, antiplatelet therapy and mechanical thrombectomy have been advanced, rapidly. Dual antiplatelet therapy for minor stroke patients during acute phase was reported to be effective to reduce neurological deterioration and recurrence. Furthermore, the evidence of mechanical thrombectomy by stent retrievers and aspiration catheters for large vessel occlusion, indicating internal carotid artery and/or middle cerebral artery occlusion, was established several years ago. This advancement of medicine might be helpful to manage the AIS patients. However, we suppose that it is not only important to advance medicine, but also make better system to treat AIS patients. First, developmental education to the people is needed to prevent AIS development and call emergency services as soon as possible after onset. Second, to make efficient emergency transport system is thought to be important to shorten the duration between onset and beginning of treatment. To achieve this objective, we have used application, named JOIN, to contact emergency services directly. Lastly, we made protocol in hospital for shortening time from door to treatment. Because increment of the number of AIS patients has tendency to increase for some time in the future, continuing to try described above might be needed.